Tourette Syndrome and Tics: A Guide for Care and Healthcare Staff

Tourette syndrome is a neurological condition that causes tics, which are sudden, repeated movements or sounds that the person cannot fully control. It is often misunderstood, and people with tics report being stared at, told off or excluded. Care and healthcare staff can make a real difference by responding calmly and without judgement. This guide explains what tics are, how they are treated and how to support people who have them.

It is general information, not clinical advice. Treatment decisions should always be made with a specialist, and staff should follow the person's own care plan.

What are tics?

Tics are involuntary movements or noises. Motor tics include blinking, shrugging or head jerks. Vocal tics include throat clearing, sniffing, grunting or words and phrases. Many people feel an urge building up before a tic, and some can hold a tic back for a while, but doing so is tiring and the tic often returns more strongly. Tourette syndrome is diagnosed where a person has both motor and vocal tics over a long period.

Swearing, which is often shown in the media, affects only a minority of people with Tourette syndrome. Most people with the condition do not have it, so staff should not expect or assume it.

What makes tics worse?

NHS information advises that stress and tiredness can make tics worse, and many people also notice that anxiety or excitement does. Tics often reduce when the person is absorbed in an activity. That is why a quiet, predictable routine, enough sleep and a calm environment can help.

Conditions that often go together

Tourette syndrome commonly occurs alongside other conditions, such as attention deficit hyperactivity disorder, obsessive thoughts and behaviours, anxiety and autism. Support plans should look at the whole person, not just the tics. Our neurodiversity at work guide covers wider neurodiversity at work.

Treatment

Many people with mild tics need no treatment. When tics cause problems, the NHS describes the following options.

Behavioural therapies

• Habit reversal therapy. The person learns to notice the urge to tic and uses a competing movement instead.
• Comprehensive behavioural intervention for tics (CBiT). A wider set of techniques, including habit reversal.
• Exposure and response prevention. The person learns to tolerate the urge to tic until it passes.

These therapies need several sessions and regular practice between them.

Medicines

The NHS lists neuroleptic medicines such as risperidone, pimozide and aripiprazole, as well as clonidine and tetrabenazine. Side effects can include weight gain, blurred vision and constipation, so staff should watch for changes and report them to the prescriber. Botulinum toxin injections are sometimes used for specific muscles, and deep brain stimulation is considered only for severe cases that do not respond to other treatment.

How staff can help

• Do not draw attention to tics. The NHS advises against punishing or calling attention to tics, and recommends reassuring the person that there is nothing to feel embarrassed about.
• Do not ask the person to stop. Suppression is tiring and can make tics worse later.
• Plan for stress. Build in breaks, quiet spaces and predictable routines.
• Protect from harm. Some tics can cause injury or pain. Tell the clinical team if so.
• Challenge stigma. Make sure colleagues, other residents or visitors understand that tics are not deliberate.
• Involve the person. Ask what helps, and respect their preferences about how tics are discussed.

Tics in care settings

Tics can come up in everyday care situations. A person in hospital or a care home may tic more during an unfamiliar routine, a noisy ward or a stressful procedure, and tics at night can disturb sleep. Staff should plan for this in advance: where possible, offer a quieter room, allow extra time for personal care and meals, and agree with the person how staff will respond if a tic causes pain, spills a drink or disturbs others. Other residents or patients may need a calm explanation that the movements and sounds are not deliberate. If tics cause injury, such as bruising from hitting a surface, or affect eating, breathing or sleep, tell the clinical team so that they can review support and treatment.

Work, learning and reasonable adjustments

Employers and teachers can support people with tics by allowing breaks, offering a quiet space for exams or focused tasks, and explaining the condition to colleagues with the person's agreement. Tourette syndrome may count as a disability under equality law, so reasonable adjustments may be required. Our reasonable accommodations guide explains the principles, and our mental health first aid guide covers how to support colleagues with anxiety or distress.

Frequently asked questions

Can a person with Tourette syndrome stop their tics?

They may be able to suppress them briefly, but it takes effort and tics often return. Telling someone to stop is unhelpful.

Do all people with Tourette syndrome swear?

No. Only a minority do.

Is Tourette syndrome a mental health condition?

It is a neurological condition, though it often occurs alongside mental health and neurodevelopmental conditions that need support.

Where can teams find training?

See the CPD hub for professional development options for care and healthcare teams.

Learnsignal will update this guide as national guidance develops.